Abstract: A binder for building materials comprising cement and mineral grinding additives, said grinding additives containing ash of burned refuse. Relative to the binder, the ash of burned refuse has a weight percent of 0.005 to 0.4 and a Blaine specific surface area of 1500 cm2/g to 6000 cm2/g.

Abstract: A flexible tubular member for guiding insertion of instrumentation to a bone screw affixed within bone includes a tubular body that is flexible, constructed of textile material, and defines a longitudinal axis. The tubular body also defines a proximal end and a distal end opposite each other along the longitudinal axis. The tubular body further defines a guide channel that extends from a proximal opening at the proximal end to a distal opening at the distal end. An attachment member is located at the distal end of the tubular body and is configured to couple the distal end to a proximal portion of the bone screw.

Abstract: A system for facilitating a medical procedure includes an access device that is configured to provide distance information regarding anatomical structures as the access device is driven to a target anatomical site. For instance, the access device can have either or both of a camera and neuromonitoring electrodes. The camera can send real-time images of the anatomical structures as the access device is driven toward the target anatomical site. The electrodes can emit an electrical current to identify a distance from nerve structure. A visual display can include the anatomical structure identified to the operator to assist in guiding the access device to the target anatomical site.

Abstract: A flexible tubular member for guiding insertion of instrumentation to a bone screw affixed within bone includes a tubular body that is flexible, constructed of textile material, and defines a longitudinal axis. The tubular body also defines a proximal end and a distal end opposite each other along the longitudinal axis. The tubular body further defines a guide channel that extends from a proximal opening at the proximal end to a distal opening at the distal end. An attachment member is located at the distal end of the tubular body and is configured to couple the distal end to a proximal portion of the bone screw. The attachment member has an annular shape around the guide channel and is configured to expand responsive to a predetermined tensile force applied to the tubular body for decoupling from the bone screw.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

Abstract: Surgical access port stabilization systems and methods are described herein. Such systems and methods can be employed to provide ipsilateral stabilization of a surgical access port, e.g., during spinal surgeries. In one embodiment, a surgical system can include an access port configured for percutaneous insertion into a patient to define a channel to a surgical site and an anchor configured for insertion into the patient's bone. Further, the access port can be coupled to the anchor such that a longitudinal axis of the access port and a longitudinal axis of the anchor are non-coaxial. With such a system, a surgeon or other user can access a surgical site through the access port without the need for external or other stabilization of the access port, but can instead position the access port relative to an anchor already placed in the patient's body.

Abstract: A retractor member is configured for insertion through a channel of an access member and for moving soft tissue at a treatment site that is accessible through the channel. The retractor includes a body having a proximal end and a distal end and spaced from each other along a longitudinal direction. The distal end defines a retractor blade and the body defines a first surface and a second surface opposite each other along a transverse direction substantially perpendicular to the longitudinal direction. The retractor includes an attachment device configured to selectively attach the body to a portion of the access member such that the body is extendable through the working channel while the body is attached to the portion of the access member.

Abstract: Systems, devices, and methods are provided for trajectory guidance using instrument position data and planned trajectories into or through a patient's body or an object. Lasers are emitted from a laser system toward the patient's body or object at an area within or proximate to the instrument operator's line of sight. Information about the instrument, including the position of its proximal and distal ends, and the position of the patient's body or object, are used to direct the emission of the lasers in real-time during operation of the instrument. The emitted lasers function as visual cues indicating the manner in which to position the distal and proximal ends of the instrument to properly align with the planned trajectory. A guidance map on the instrument can be used to output visual cues about the position of the distal and proximal ends of the instrument relative to a planned trajectory.

Abstract: A flexible auger design for low-torque transmitting drive shafts, which allows effective tissue material transport through curved, flexible tubes and channels. A hollow auger has a hollow center, so that the helical member hugs the inner wall of the tube and material is transported along the center axis and the inner wall of the tube. The hollow flexible auger allows for transportation of material from an operative location in the patient (material removal) as well as to operative location in the patient (material delivery).

Abstract: Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

Abstract: Surgical access port stabilization systems and methods are described herein. Such systems and methods can be employed to provide ipsilateral stabilization of a surgical access port, e.g., during spinal surgeries. In one embodiment, a surgical system can include an access port configured for percutaneous insertion into a patient to define a channel to a surgical site and an anchor configured for insertion into the patient's bone. Further, the access port can be coupled to the anchor such that a longitudinal axis of the access port and a longitudinal axis of the anchor are non-coaxial. With such a system, a surgeon or other user can access a surgical site through the access port without the need for external or other stabilization of the access port, but can instead position the access port relative to an anchor already placed in the patient's body.

Abstract: A retractor member is configured for insertion through a channel of an access member and for moving soft tissue at a treatment site that is accessible through the channel. The retractor includes a body having a proximal end and a distal end and spaced from each other along a longitudinal direction. The distal end defines a retractor blade and the body defines a first surface and a second surface opposite each other along a transverse direction substantially perpendicular to the longitudinal direction. The retractor includes an attachment device configured to selectively attach the body to a portion of the access member such that the body is extendable through the working channel while the body is attached to the portion of the access member.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: A flexible auger design for low-torque transmitting drive shafts, which allows effective tissue material transport through curved, flexible tubes and channels. A hollow auger has a hollow center, so that the helical member hugs the inner wall of the tube and material is transported along the center axis and the inner wall of the tube. The hollow flexible auger allows for transportation of material from an operative location in the patient (material removal) as well as to operative location in the patient (material delivery).

Abstract: Navigated instrument guide systems and related methods can identify an absolute position of an instrument received within an instrument mount of a robotic arm. A navigation array unit of the guide system can include a main array and a mounted array. The main array can identify a position of the robotic arm and the instrument mount, while the mounted array can identify a depth position of a distal end of an instrument received within the instrument mount. The instrument can be passed through a lumen of the mounted array as the instrument is inserted into the instrument mount. The mounted array can be configured to translate relative to the instrument mount and the main array with distal translation of the instrument. In this manner, a position of the mounted array can identify a depth position of the instrument without a mechanical connection between the mounted array and the instrument.

Abstract: An implant for insertion into a disc space between vertebrae, wherein the implant includes a spacer portion, a plate portion coupled to the spacer portion, two bone fixation elements for engaging the vertebrae and a retention mechanism for preventing the bone fixation elements from postoperatively backing-out of the plate portion. The retention mechanism may be in the form of a spring biased snapper element that is biased into communication with the bone fixation elements so that once the bone fixation element advances past the snapper element, the snapper element is biased back to its initial position in which the snapper element interfaces with the bone fixation elements. Alternatively, the retention mechanism may be in the form of a propeller rotatable between a first position in which the bone fixation elements are insertable to a second position where the bone fixation elements are prevented from backing-out.

Abstract: An intervertebral implant component of an intervertebral implant includes an outer surface for engaging an adjacent vertebra and an inner surface. A keel extends from the outer surface and is designed to be disposed in a slot provided in the adjacent vertebra. This keel extends in a plane which is non-perpendicular to the outer surface; and preferably there are two of the keels extending from the outer surface which are preferably offset laterally from one another. In another embodiment, an anterior shelf is provided at an anterior end of the outer surface, and this anterior shelf extends vertically away from the inner surface in order to help prevent bone growth from the adjacent vertebra towards the inner surface. Further in accordance with disclosed embodiments, various materials, shapes and forms of construction of the component and/or keel provide various benefits.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Systems, methods, and devices are disclosed for robotic surgical systems including a robotic arm, the systems comprising an end effector attached to the robotic arm and retaining an access guide, and an initial access tool detachably connected to the access guide, wherein the initial access tool comprises a housing, a shaft extending from the housing coaxially through the access guide, and a distal tip attached to the shaft and protruding from a portion of the access guide distal to the end effector, wherein the housing is adapted to prevent rotation with respect to the access guide. In some embodiments, the access guide is adapted to retain an initial access tool and one or more of a burring tool, a drilling tool, or a tapping tool.